GRADE 3 AND 4 DROWNINGS IN THE PARANÁ MILITARY FIRE DEPARTMENT (2014–2025): INSTITUTIONAL EVALUATION OF RESPONSES, SEVERITY CLASSIFICATION, AND PROSPECTS FOR IMPROVEMENT

Abstract

Drowning is a public health problem that is decreasing every year, but the number as a whole is still significant. In the search for improvements in drowning care, this research aims to assess, based on the perceptions of lifeguards from the Paraná Military Fire Brigade, how difficulties and barriers in checking the radial pulse influence the differentiation between grade 3 and 4 drownings and the care and referral decisions of victims in the health system, in incidents recorded between 2014 and 2025, in order to identify critical points and subsidize the improvement of classification protocols and the conduct of drowning rescue. The methodology used was to search the victim monitoring reports for grade 3 and grade 4 drownings from 2014 to 2025, in parallel with the application of forms to 68 of the 87 lifeguards who worked on these cases, making this an observational, descriptive study with quantitative and qualitative analysis. The data obtained underwent initial statistical treatment and content analysis. The results showed a low number of deaths among victims in grades 3 and 4, but there was evidence of insecurity among lifeguards when differentiating the degrees of drowning based on the radial pulse, and 36% of those involved were unsure when providing assistance. Another point was the difficulties that influence this action, such as weak pulse, cold, fatigue, instability of the environment and time pressure. Gaps in specific training and poor recording of hemodynamic assessment were also identified. The conclusion is that there is a need to improve training, which can be minimized with real simulations, with a focus on circulatory assessment, and better standardization in the registration of occurrences of victims in grades 3 and 4 with the incident report of a person in a liquid environment, seeking a better categorization of these drowning grades and technical support for pre- and in-hospital care.